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A ° ° ® CERTIFICATE OF LIABILITY INSURANCE 05/ THIS CERTIFICATE IS ISSUED AS A MATTER OF IN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poliey(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT rvaME: H araold Griffith Griffith Insurance &Financial Services, Inc PHONE 323- 56 4 -91 _ FAX 323 -564 -2 788 GIFS r C j yo ,ExU _ teyc EQDRF ha rold riffi @aol.c 4000 Tweedy Blvd AO-°RE�-- 9 South Gate r_... IN _ NA _ _ _ _ -- - — —` CA _,, INSURERA • Llo d' a of London IN- -'— ____ `_ ._, y ,. —_ _..�_ _ RERB:United Financial Casul C o YENSON LUNCH INSU — - -- - - -_, INSURER C_ ! 10290 Beverly St -•- - -- —_ _.— _ Bellflower CA 90706 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IR Tn f:FRTICV T-1 TI.IC o D- �AVr bti-N Ij5UL:U TO THE INSURED NAMED ABOVE FOR THE PE INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED CONTRACT OR OTHER DOCUMENT WITH RESPECT TO T BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIO AN D CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE INS—R- ADDrSU89— B EEN REDUCE BY P AID CLAIMS. TR TYPE OF INSURANCE POLICY NUMBER ' — MM I MMI EX Y I GENERAL LIABILITY I OME019101 f LIMITS EACH OCCURRENCE S 1, 00 0, 000 .� COMMERCIAL GENERAL L ABILITY � I1/25/13' 01/25/12 0 �DAINA ,l�E Tb N tT�D CLAIMS -MADE OCCUR PREM ( ca occu ne e) S S 0, 000 A i MED FL XP one pers on) 5 _ 2, 000 _ D e 500 !� d PE RSONALBAOV I Is 1, 00 000 _ GEIJ'L AGGREGATE LIMIT AP PER: I I GEN ERAL AGGREGA ; S 2, 000 000 PRO- POLICY LOC I ._ PRODUCTS - CD.V.P / AGG S 1,000, AUTOMOBILE LIAB W TY I S A 08408285 -0 O1/ 1201/23/13 a6cadeDl IN LE LIMIT ANY AUTO _ i B ALL OWNED r ' — '! SCHEDULED AUTOS _LEa s --7 50_�_QQD I BODILY INJURY ( Per person) ( rson) S �, AUTOS NON 600IL Y IN {Per Oc OWNED -, HIRED AUTOS ••-, AUTOS PROPERTY DAMAGE �S Per accident , S UMBRELLA LIAB OCCUR S I EXCESS LIAB CLAMS -MADEi EACH OC CURRENC E S - DED I I . RETENTIONS j AGGR EGATE I S WORKERS COMPENSATION I ; S AND EMPLOYERS' LIABILITY I Y/M 1/YC STATU- OTH- I ANYPROPRIETOR:PARTNERrEXECUTIVE I-- �L lm E_ ,— R EXCLUDED? ❑ NIA. A a p �� ' RU 'MINIM p I E,L. EACH ACCIDENT S (Ma (M nddatory In N ER ry In N H) ; •- �•�- ��+'^�p"�r�� It yes, describe urWer DESCRIPTION OF OPERATIONS below I i E L. DISEASE - EA EMPLOYEE S ! I E.L. DISEASE POLICY LIMIT S t I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If — is space required) CERTIFICATE HOLDER CANCELLATION Additional Insured CITY OF RIVERSIDE 3900 Main Street Riverside CA 92522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE f TJREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE 171-1 Epp Y PROVISIONS. ACORD 25 (2010105) O The ACORD name and logo are registered marks of ACORD ORD CORPORATION. All rights reserved.